Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang-si, 14068, Republic of Korea.
Department of Ophthalmology, Hallym University College of Medicine, Chuncheon, 24252, Republic of Korea.
Eye (Lond). 2024 Jan;38(1):82-88. doi: 10.1038/s41433-023-02635-4. Epub 2023 Jun 23.
To investigate the long-term outcomes of oral doxycycline as first-line treatment in patients with conjunctival extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma).
In this case series, the medical records of 67 patients with conjunctival MALT lymphoma who received doxycycline as their primary treatment and were followed up for at least 5 years were retrospectively reviewed. Progression-free survival (PFS) was analysed at 3, 5, and 10 years after the initial doxycycline treatment. A Cox proportional hazards model was used to assess the independent risk factors for progression.
After the initial treatment, 25 patients (37.3%) achieved a complete response, 8 patients (11.9%) achieved a partial response, 30 patients (44.8%) showed stable disease, and 4 patients (6.0%) showed disease progression. The median PFS in all patients was 168 months, and the 3-, 5- and 10-year PFS rates for all patients were 70%, 65%, and 62%, respectively. No further progression was observed 6 years after the initial doxycycline treatment. Younger age and TNM stage T1c were significant risk factors for the time to progression in the multivariate Cox regression analysis (p < 0.05). Additional doxycycline (>2 cycles) showed no benefit. There were no serious adverse events associated with doxycycline therapy, and most patients were successfully salvaged by second-line treatments, including radiotherapy and chemotherapy.
In this case series, oral doxycycline treatment yielded acceptable long-term PFS with minimal complications. Especially in patients with stage T1a or T1b conjunctival MALT lymphoma, first-line doxycycline treatment could be considered under close monitoring for at least 6 years.
研究口服多西环素作为黏膜相关淋巴组织（MALT 淋巴瘤）结膜结外边缘区 B 细胞淋巴瘤一线治疗的长期疗效。
在本病例系列研究中，回顾性分析了 67 例接受多西环素作为一线治疗并至少随访 5 年的结膜 MALT 淋巴瘤患者的病历。在初始多西环素治疗后 3、5 和 10 年分析无进展生存（PFS）。采用 Cox 比例风险模型评估进展的独立危险因素。
初始治疗后，25 例（37.3%）患者完全缓解，8 例（11.9%）部分缓解，30 例（44.8%）疾病稳定，4 例（6.0%）疾病进展。所有患者的中位 PFS 为 168 个月，所有患者的 3、5 和 10 年 PFS 率分别为 70%、65%和 62%。初始多西环素治疗后 6 年未发现进一步进展。多因素 Cox 回归分析显示，年龄较小和 TNM 分期 T1c 是影响进展时间的独立危险因素（p<0.05）。多西环素（>2 个周期）的追加治疗没有获益。多西环素治疗没有严重的不良反应，大多数患者通过二线治疗（包括放疗和化疗）成功挽救。
在本病例系列研究中，口服多西环素治疗具有可接受的长期 PFS，且并发症少。特别是在 T1a 或 T1b 期结膜 MALT 淋巴瘤患者中，至少在 6 年的密切监测下，可以考虑一线多西环素治疗。
